Earticle

Glycolysis and oxidative phosphorylation are the two main metabolic pathways used by cells. However, the Warburg effect indicates that under aerobic conditions, tumor cells still prefer glycolysis over efficient oxidative phosphorylation to provide energy. Recently, the inhibition of tumor cell growth through metabolism pathways has received widespread attention. In this study, 2-deoxy-d-glucose (2DG), a glycolysis inhibitor, was introduced into a hydrogel system fabricated by forming covalent and hydrogen bonds with doxorubicin (DOX) and cellulose nanocrystals (CNC). The designed CNC-assembled hydrogel (CAH) system was self-assemble, injectable, and biocompatible. Moreover, DOX worked synergistically with 2DG, accomplishing multiple therapeutic functions against melanoma by targeting both chemical and metabolic pathways, including the inhibition of glycolysis and the enhancement of lipid peroxidation. Notably, compared to the control group, the ATP level of CNC/DOX/2DG decreased by 23% while NADPH level has decreased by 25% in B16F10 cells. Additionally, cleaved caspase-3 and caspase-7 levels were elevated following treatment in B16F10 cells. The CAH system can provide prolonged chemometabolic effects for combating melanoma.

Although systemic therapies for bone loss are well established, localized bone augmen-tation approaches remain less mature overall. This unmet need is driving a shift toward localized, minimally invasive strategies. In receptor activator of NF-κB ligand (RANKL) reverse signaling—a distinct, osteoanabolic pathway compared with the canonical receptor activator of NF-κB (RANK)–RANKL–osteoprotegerin (OPG) resorptive axis—RANKL, normally a ligand, acts as a receptor on osteoblast-lineage cells, where membrane accumulation and clustering trigger pro-osteogenic sig-naling. Peptide activators of this pathway (OP3-4, W9) are effective, but their performance depends on scaffold properties that sustain local release and provide multivalent presentation to drive RANKL membrane accumulation and clustering. This review synthesizes recent advances in scaf-fold platforms engineered to enable and amplify RANKL reverse signaling, with emphasis on gel-atin hydrogels, cholesteryl-bearing pullulan (CHP) nanogels, and injectable microparticle systems. We articulate design principles—release kinetics, porosity/architecture, and chemical modifica-tion—that govern local bioavailability and effective ligand valency, and we outline how these prin-ciples extend to RANK-bearing extracellular vesicles. Finally, we outline practical criteria for pair-ing RANKL-binding peptides with scaffolds compatible with non-surgical injectable delivery and discuss translational considerations for future clinical use.

Background : Currently, most clinical trials are conducted on adults. Also, dose formulations are developed based on adult standard doses, resulting in problems with pediatric administration. Firstly, the excess drugs become medical waste. Secondly, patients may be overcharged even when they only use a small portion of the drugs. Lastly, medical errors may arise while preparing and administering pediatric doses with comparatively large dose formulations. Therefore, this study aimed to analyze the status of injectable drug use in pediatric inpatients and estimate the discarded drug amounts and the proportion of the actual dose used, thus evaluating the marketability of lower dose formulations. Methods : The data of injectable drugs prescribed from June 1, 2018, to May 31, 2019, were collected and retrospectively analyzed using the Order Communication System program. Results : The average daily injectable drug prescriptions for children were 1,738.1, and 40.1% of them were for less than the dose formulations. The number of injections discarded daily was 435.7, accounting for 1,692,217 Korean won. The injectable drugs frequently prescribed in small proportions were dexamethasone 5 mg/ampoule (A), ranitidine 50 mg/A, cimetidine 200 mg/A, and furosemide 20 mg/A. Among the top 20 products, only seven had lower dose formulations available in Korea, of which three were unavailable due to low demand, never produced though granted permission, and one was due to non reimbursement by insurance. Moneywise, the biggest loss was from caspofungin 50 mg/vial (V), whose daily drug disposal accounted for 256,352 Korean won, followed by smoflipid 20%® 100 ml/bottle, ganciclovir 500 mg/V, and teicoplanin 200 mg/V. Conclusion : This study showed that utilizing injectable drugs with adult dose formulations for children could result in biohazardous medical waste and economic losses. However, there are only a few alternatives currently available. Therefore, the government, instead of individual medical institutions or pharmaceutical companies, should authorize the investigation and development of lower dose formulations for children.

Background : Injectable drug incompatibilities are major concerns because they may increase the risk for patient safety and therapy cost. Thus, it is necessary to review drugs-fluids compatibility for reducing drug administration errors. Seoul St. Mary’s Hospital developed a review program for injectable drugs-fluids com patibility in 2021 and applied it in October 2022. This study aimed to assess effectiveness of the review program and check for further enhancement. Methods : This single-center, retrospective study assessed the efficacy of the review program by compar ing data from periods before (April to June 2022) and after (April to June 2023) introducing the program. We retrospectively analyzed prescriptions for drugs subject to review (35 items total) and examined incidence of damaged parenteral drugs and the number of inquiries regarding physicochemical incompatibilities to drug in formation center. Additionally, the utilization and satisfaction of the program were investigated through a survey of nurses. Results : The accuracy of prescriptions was significantly increased after introducing the review program (35.8% vs. 44.6%, p<0.001), while incidence rates of cases of damaged drugs (2.5% vs. 0.7%, p=0.004) and inquiries (40.4% vs. 21.4%, p<0.001) were significantly decreased. Of 210 appointment and CP prescriptions that required revision, 158 (75.2%) cases were revised. Prescription completeness also improved from 87.1% to 94.3% (p<0.001). Of 128 nurses who responded that they were aware of the newly created ‘Injection Mixing and Administration’ tab, the most frequently referenced details were reconstitution solvent (122 people), diluted infusion solution (107 people), and fluids-incompatibility (89 people). Of 120 nurses who answered that provid ing information was helpful to their work, 29.8% experienced a reduction in work hours because it was easy to acquire information regarding compatibility. Conclusion : Findings from our study showed that the review program and provision of drug information increased utilization of work. If the scope of drugs subject to review is expanded, work is expected to be more efficient. It is also possible to prevent patient safety accidents.

Background : Atypical long-acting injectable antipsychotics (LAIA) have been used on psychiatry patients since 2003 to solve drug lowing adherence. However, prior studies on drug patterns and trends are lacking. The purpose of this study was to offer base data of pharmacotherapy by analyzing the trends or characteristics of each long-acting injection (LAI). Methods : Prescription data were collected by electronic medical record on outpatient of the psychiatry department of a National Mental Hospital 2011 to 2020. Total 4,292 LAIs prescriptions were obtained and analyzed retrospectively on sex, age, medical insurance, diagnosis, concomitant drugs by χ2 test and frequency analysis. Results : LAIA were increased during the last 10 years (P<0.001). Those were increased on age for 18-34 (P=0.018) and age 35-64 (P=0.009) and decreased on older than age 65 (P<0.001), and no difference on sex (P=0.136). Significantly, prescription rate of each LAI was different from sex, age, health insurance. Each LAI was used higher in schizophrenia while aripiprazole LAIs were used in bipolar (P<0.001). Concomitant drug rate was 59.5%. Aripiprazole LAIs (37.1%), risperidone LAIs (55.4%) were prescribed at monotherapy. The number of concomitant drug was 1.50±1.825 in polypharmacy. Each LAI showed significant difference in the frequency of use of the concomitant drug efficacy group, antipsychotics were used the most. LAIs used a variety of 115 concomitant drugs. Conclusion : The use of LAIA increased, and LAIs were used with a variety of drugs. If pharmacists review the drug interaction of LAIs and offer detailed explanations, they can serve to reduce spontaneous discontinuation and to improve compliance of LAIs.

Background : We aimed to investigate the current dispensing behavior, and the status of patient education on self-injectable medications in Korea hospitals. Methods : This cross-sectional questionnaire study was conducted through an e-mail survey. Questionnaires were distributed to 240 pharmacy department representatives in the general or higher level of hospitals; the representatives are members of the Korean Society of Health-system Pharmacists. The survey items included characteristics of the hospital, distribution sites of the self-administered injections, provision, provider and educational materials of the patient education, and appropriateness of the education provided to patients. Results : Among the 240 representatives, 56 representatives (23.3%) responded, and tertiary general hospitals accounted for 66.0% (37 institutions). Self-injectable medications were dispensed in the hospital, mainly by the pharmacy department, however, injectable antidiabetics and anitobesity were dispensed both in and out of the hospital pharmacies in many hospitals (91.1% and 73.2%, respectively). The main patient education were nurses (64.3%). Regular re-education was provided to a limited proportion (0.6%). From the provider’s point of view, the appropriateness of self-injectable medication education provision was evaluated with an average score of 3.5 on a 5-point scale. Conclusion : In conclusion, most self-injectable medications were dispensed in in-hospital pharmacies except anitobesity and anitobesity drugs. The initial education was mainly provided by nurses and regular re-education was provided on a limited basis. In addition, we highlighted the need for improving the provision of patient education on self-injectable medications.

Background : Closed system drug transfer devices (CSTDs) are recommended in the US, Europe, and Japan, to reduce the risks associated with the compounding of anticancer drugs. However their high cost limits their use in South Korea. This study aimed to evaluate the effectiveness of CSTD use in reducing leakage, compounding time, and user satisfaction compared to traditional compounding devices for in jectable antineoplastic agents in a tertiary hospital. Methods : Needle compounding was compared with two closed system drug transfer devices (CSTDs), CSTD A and CSTD B, from different companies that utilize distinct methods. Four pharmacists compounded cyclophosphamide and doxorubicin, employing CSTD A’s multi vial adaptor exclusively for doxorubicin. Drug leakage onto gloves, the compounding board, and IV bags was analyzed using liquid chromatogra phy-tandem mass spectrometry. Additionally, satisfaction surveys were completed by four pharmacists and six nurses, employing a 5-point scale. The Mann-Whitney U test (p < 0.05) was used to compare leakage and preparation time. Results : For cyclophosphamide, needle compounding showed more leakage than CSTD A on the com pounding board (257.54 vs. 0.09 ng/cm2) and IV bags (29.33 vs. 0 ng/cm2). It also showed more leakage than CSTD B on gloves (550.64 vs. 0.07 ng/cm2) and the compounding board (257.54 vs. 0 ng/cm2). For doxorubicin, needle compounding had significantly more leakage on the compounding board compared to CSTD A (9.88 vs. 0 ng/cm2), whereas CSTD B displayed more leakage than needle compounding on the compounding board (12.13 vs. 9.88 ng/cm2) and IV bags (52.79 vs. 0 ng/cm2), although this difference was not statistically significant. Needle compounding was faster than both CSTDs for both cyclophospha mide and doxorubicin. Pharmacists favored CSTD A (4.01), while nurses preferred CSTD B (4.06). Conclusion : CSTDs significantly reduced drug leakage compared to needles. Although CSTDs in creased compounding time, overall satisfaction supported their usage. These findings highlight the need for the adoption of CSTDs in South Korea to ensure safety, despite their higher costs.

척추질환에 일반적으로 사용하는 척추경 나사못, 케이지, 플레이트 등의 단점을 보완하고자 인체의 유체를 흡수 하여 영구적 수화상태와 압력을 유지할 수 있는 수핵충진용임플란트가 대두되고 있으나, 아직 수핵충진용임플란트에 대 한 평가방법이 미흡한 실정이다. 따라서 본 연구는 척추질환과 관련된 정형용 인체 삽입형 의료기기를 바탕으로 미국, 유럽 등 국내·외 기술 개발동향 및 규격, 국내·외 허가 시 적용된 시험 등을 조사·분석하여 수핵충진용임플란트의 물리·기계적 특성 평가를 위한 시험항목 및 방법을 도출하고 시험 수행을 통해 이에 대한 검증을 실시하였다. 본 연 구를 통해 마련된 수핵충진용임플란트의 물리·기계적 시험 방법은 향후 제조업체에서의 해당 품목 개발에 도움을 줄 수 있을 것으로 기대한다.

Pedicle screws, cages and plates are typically used for general lumbar spine disc diseases. However, it has been revealed that they have a number of defects and therefore nucleus pulposus implant, which can maintain permanent hydration condition and pressure by absorbing fluids of the human body to overcome such defects, is emerging as their replacement. However, as there have been fewer methods to evaluate nucleus pulposus implant. This study is technical development trends for forms and materials of nucleus pulposus implant not only in Korea but also in foreign countries such as the United States and Europe were analyzed. In addition, document reviews of relevant standards including ISO documents and related literature along with investigation and analysis of testing items and methods which are nationally and internationally recognized were performed to draw testing items and methods to evaluate the physical and mechanical characteristics. The items and methods were also verified by testing. As a result of this study might support the product development.

이대목동병원 신생아 중환자실 환아 4명이 인큐베이터 안에서 치료를 받고 있던 중 숨지는 사고가 발생했다. 이에 대해 국립과학수사연구원은 사인을 시트로박터 프룬디균 감염에 의한 패혈증으로 추정하면서 주사제 및 취급 과정 중 오염에 의한 감염가능성이 있다고 했다. 이대목동병원 신생아 중환자실 사망사고 원인이라고 추정되는 문제는 병원 내 감염관리 문제, 의료인력 부족으로 인한 문제, 주사제 분주문제 등이 있다. 국민의 건강을 보호하기 위해서는 의약품을 제조하는 단계에서부터 이력추적을 통해 해당 의약품의 안전관리가 보장될 필요가 있다. 본고에서는 의약품 안전관리 현황과 주사제 안전관리에 대해서 검토한 후 주사제 분주문제에 관한 문제점과 해결방안을 검토해 보았다. 연구결과 다음과 같은 개선방안을 마련하게 되었다. 첫째, 미흡한 주사제 소량포장을 의무화해야 한다. 이를 위해서는 ｢의약품 소량포장단위 공급에 관한 규정｣에서 주사제의 소량포장을 의무화할 필요가 있다. 둘째, 주사제를 1병 1환자로 의무화 하더라도 주사제에 대한 관리체계가 병원자율에 맡겨져 있어, 원천적으로 예방하는 데 한계가 있다. 따라서 ｢의약품 바코드와 RFID tag의 사용 및 관리요령｣[별표 1의 2]에서 수액류 관련 예외 사항을 삭제하는 것이 필요하다.

Four premature babies died while treated in the neonatal intensive care unit at Ewha Womans University Mokdong Hospital. The National Forensic Service suspected that the consecutive deaths were caused by blood poisoning brought about by the bacteria Citrobacter freundii, raising the possibility that the injectable drugs had already been contaminated or become contaminated in the preparation process before administered to the babies. The possible causes of this unfortunate incident lie in such problems as inadequate infection control, lack of medical personnel and divided use of injection solution at hospital. Public health necessitates safety management of drugs by ensuring traceability from the manufacturing stage. This study examined the current status of safety management of drugs including injectable ones and explored problems associated with divided use of injectable drugs and solutions to the problems. The study suggests the following ways for improvement. First, the duty to produce small packaged drugs needs to be performed more strictly. To this end, the Regulations on Small Volume Packaging Supply of Drugs have to prescribe a mandatory obligation concerning small volume packaging of injectable drugs. Next, even though the "one bottle of injection solution for one patient" duty becomes mandatory, managing injectable drugs is still left to the discretion of hospitals, which will make the duty less workable. It is, therefore, required to delete the provisions on exceptive cases of injections in the attached Table 1-2 to the Guidelines on the Use and Management of Barcodes and RFID Tags for Drugs.

Thermo-sensitive hydrogels are commonly used in many biomedical and pharmaceutical applications, including tissue engineering and drug delivery systems. Due to their sensitivity to thermal stimulus, they have a great potential in site-specific controlled drug-delivery systems. A new class of injectable and bioabsorbable supramolecular hydrogels, which are formed from poly(ethylene oxide) (PEO) and α-cyclodextrin (α-CD), have been investigated for controlled drug delivery. In this study, we examined the release profiles of several poorly water-soluble drugs from these new biodegradable hydrogels. Physically crosslinked hydrogels were prepared from mixed aqueous solutions of PEO and α-CD using a temperature-controlled gelation technique at various concentrations of both compounds. The drug release profiles of several drugs from hydrogels were determined in vitro via dialysis using high-performance liquid chromatography.

The Intervertebral disc is a composite structure made up of the nucleus pulposus (NP) core surrounded by the multi-layered fibers of the annulus fibrosis (AF)[1]. Water is drawn into the NP by the presence of hydrophilic proteins called proteoglycans [2]. The AF, with successive layers oriented in alternating directions, surrounds the NP. These layers are placed under tension as the NP absorbs water and swells [3]. (omitted)

Gingival black triangles, resulting from loss of the interdental papilla (IDP), adversely affect esthetics, phonetics, and periodontal health, and injectable platelet-rich fibrin (i-PRF) a growth factor-rich platelet concentrate, has emerged as a promising minimally invasive regenerative approach for papilla reconstruction. This study evaluates the clinical effectiveness of i-PRF in the management of gingival black triangles and IDP deficiencies. A systematic review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420261321819). Electronic searches of studies including human studies were performed for studies published between 2020 and 2025. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials and the JBI checklists for case reports and series. Fourteen studies met the inclusion criteria, including randomized controlled trials (RCTs), pilot studies, case series, and case reports. Most studies reported improvements in papillary height, papilla presence index, and reduction in black triangle dimensions following i-PRF therapy. Clinical outcomes were generally comparable to hyaluronic acid injections and connective tissue graft procedures, with reduced invasiveness and postoperative discomfort. i-PRF appears to be a promising minimally invasive option for managing gingival black triangles; however, larger RCTs with longer follow-up are needed to confirm long-term effectiveness.

Aging-related changes in the skin, such as dullness, dehydration, and loss of elasticity, significantly affect its appearance and integrity. Injectable "skin boosters," comprising various biological materials, have become increasingly prominent in addressing these issues, offering rejuvenation and revitalization. This review offers a comprehensive examination of these injectables, detailing their types, mechanisms of action, and clinical uses. It also evaluates the evidence for their effectiveness and safety in treating age-related skin alterations and other conditions. The goal is to provide an insightful understanding of injectable skin boosters in contemporary dermatological practice, summarizing the current state of knowledge.

Laboratory column experiments were conducted to evaluate the feasibility of injectable apatite method for the sequestration of Sr-90 in groundwater. The columns were tested to evaluate the rate of citrate biodegradation, the amounts of apatite formed, and the treatability of strontium by the sediment and apatite. The results showed the decreases in citrate, calcium, and phosphate concentrations and the increases in alkalinity and citrate degradation products (acetate and formate) in the columns, suggesting that the citrate degradation and formation of calcium phosphate are occurring. Although the calcium and phosphate were not completely consumed within the columns, some amounts of apatite were formed and it showed an ability to treat strontium in groundwater. This study provides a fundamental understanding of reaction mechanisms for the injectable apatite sequestration method for Sr-90 removal.

Injectable gel composed of egg phosphatidylcholine (egg PC), hyaluronate (HA) and water was formulated for local drug delivery. The lamellar liquid crystalline structure of the egg PC/water system did not change by adding HA in the formulation. However, egg PC/HA/water gel was more resistant to erosion than the egg PC/water gel. The egg PC/HA/water and egg PC/water gels containing model drugs, tetracycline and sudan IV were prepared to perform in vitro and in vivo drug release experiments. In vitro release of tetracycline was sustained in the gel type formulations. The release rate of hydrophobic sudan IV was extremely slow. More than 99% of sudan IV remained inside the gel after 5 days. In vivo release of drugs from the air pouch model in Balb/c mice shows that lipophilic sudan IV remained for more than 10 days whereas tetracycline remained for 1 day in the pouch. The compatibility of the gels was also examined by histopathology. The gels did not cause any adverse inflammatory effect in the air pouch.

platelet-rich fibrin (i-PRF) a growth factor?rich platelet concentrate, has emerged as a promising minimally invasive regenerative approach for papilla reconstruction. This study evaluates the clinical effectiveness of i-PRF in the management of gingival black triangles and IDP deficiencies. A systematic review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420261321819). Electronic searches of studies including human studies were performed for studies published between 2020 and 2025. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials and the JBI checklists for case reports and series. Fourteen studies met the inclusion criteria, including randomized controlled trials (RCTs), pilot studies, case series, and case reports. Most studies reported improvements in papillary height, papilla presence index, and reduction in black triangle dimensions following i-PRF therapy. Clinical outcomes were generally comparable to hyaluronic acid injections and connective tissue graft procedures, with reduced invasiveness and postoperative discomfort. i-PRF appears to be a promising minimally invasive option for managing gingival black triangles; however, larger RCTs with longer follow-up are needed to confirm long-term effectiveness.

This study compared the effect of injectable combinations of anesthetics on each of the fluorescein angiographic phases in order to determine the most useful anesthetic combination for the procedure. Acepromazineketamine (AK), xylazine-ketamine (XK), diazepam-ketamine (DK) and zolazepam-tiletamine (ZT) group were administered randomly to 8 dogs with a two-week interval between different combination doses. The vital signs including the heart rate and arterial pressure were measured before anesthesia and every five minutes during anesthesia. Serial angiographic images were obtained after injecting a sodium fluorescein dye (25 mg/kg) and the onset time of arterial phase (AP), arteriovenous phase (AVP), early venous phase (EVP) and late venous phases (LVP) were recorded. The onset time of the AP, AVP and EVP were significantly slower in the AK and XK groups than in the DK and ZT groups. The total duration of the AP and AVP in the AK group was significantly longer than those in the ZT group. The heart rates were significantly higher in the DK and ZT groups. The arterial pressure was significantly higher in the AK and XK groups (p<0.05). There were significant differences in each angiographic onset time and duration depending on the changes in the heart rates and arterial pressure. The AK and XK groups showed a long angiographic duration allowing an accurate evaluation. Overall, it is believed that AK and XK are more useful for performing fluorescein retinal angiography than DK and ZT.